Approaches to supporting a weaning journey, with Katy Baker-Cohen

There are as many approaches to weaning as there are nurslings, so in this episode, I thought I’d get another perspective from an IBCLC across the pond. Katy Baker-Cohen works with the Nurse Family Partnership and has her own private practice called Crescent Lactation Care based in Pennsylvania. Together we talk about our approaches to transitioning from breastfeeding, how to talk about bed sharing, methods of night weaning, and which methods we don’t encourage for families choosing parent-led weaning.

Find out more about Katy at https://www.crescentlactationcare.com/

She is @‌crescentlactationcare on instagram

My new book, ‘Supporting the Transition from Breastfeeding: a Guide to Weaning for Professionals, Supporters and Parents’, is out now.

You can get 10% off the book at the Jessica Kingsley press website, that's uk.jkp.com using the code MMPE10 at checkout.

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

Resources mentioned - 

“the no man’s land of lactation” Finding the answers to your weaning questions right in your own heart. Crescent Lactation Care

Sleep, Changing Patterns In The Family Bed — Jay Gordon, MD, FAAP (drjaygordon.com)

Breastfeeding Grief | Professor Amy Brown

When Breastfeeding Sucks: What you need to know about nursing aversion and agitation, by Zainab Yate

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

Transcript

Hi. I'm 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 to join me for conversations on how breastfeeding is amazing. And also, sometimes really, really hard. We'll look honestly and openly about that process of making milk. And of course, breastfeeding and chest feeding are a lot more than just making milk. 

Emma Pickett  00:46

Thank you very much for joining me today. Before we go any further, I should just apologise if I do sound a bit bunged up because I'm dealing with a bit of a cold at the moment. And Katy, who I'm going to speak to has got a bit of hay fever going on. So you'll have to forgive us if we do sound a bit snotty. I'm really honoured today to talk to Katy Baker Cohen, who is an IBCC, based in Philadelphia in America. And her organisation is crescent, lactation care, obviously, I'll put all the links in the show notes, so you can find her and talk to her. And we're going to have a little professional matter about being lactation consultants, who support the end of breastfeeding, and who support weaning, and why we think that's important. And we're going to have a little chat about our approaches. We've never had this conversation we could discover we're completely philosophically opposed. And we could have a vicious, loud argument on this podcast, who knows where it's gonna go. But we're just going to chat through our practice and talk about why we think it's important to support ending breastfeeding. Thank you very much for joining me today, Katy,

Katy Baker Cohen  01:42

thank you so so much for having me. It's an honour, I just saying I just finished reading your book. And now I feel like I'm talking to a superstar and weaning lactation.

Emma Pickett  01:52

Very sweet to say that at the beginning, I will send the check in the post, that's very clear to your reader, because it's not been up very long. So thank you very much for taking the time to read that I'm very honoured that you did. Tell me a little bit about your professional background. So I know in the states that people come to being an ibclc, from lots of different places, what was your background and what led you to where you are now?

Katy Baker Cohen  02:14

it's hard to I think like any ibclc it's hard to not say it without like talking about your first kid if you do have kids, but you know, my son is now he was born 2012 So I was not a lactation consultant then and you know, had lactation hard times with him. But I was in, I had just become a nurse. So I'm a registered nurse and have been a maternal child public health nurse home visitor since 2014. And that we do a lot of lactation work within that. Within that job. We support first time low income families from pregnancy until their baby turns two. And so I still currently do that job full time as well. And so it was within that job, we got a grant to support some of us nurses to kind of proceed to become lactation consultants. And so I kind of got my hours and mentorship through our supervisor there and through the families we work with there and then shadowing some other local lactation consultants. So I have been a lactation consultant since 2017. Just I was my daughter was born. My second kid was born in 2016. And so I was studying for the ibclc during her pregnancy and became a lactation consultant right after she was born.

Emma Pickett  03:30

Okay, brilliant. So we are coming at it from very different angles. So I'm I'm the the layperson. Without the health professional background, I was a teacher. I was a deputy head in or vice principal in London, when I got into peer support and not not out La Leche League, but the association of breastfeeding mothers became breastfeeding counsellor fell into becoming a lactation consultant from that background. So you're the health professional perspective, which I think probably is more common in the States. I would say it sounds as though it's more common for somebody who is working as an ibclc in America to be a healthcare professional. Do you ever meet ibclcs who have come from a kind of La leche league leader background? Who aren't peer health professionals? What's common in the States? Would you say?

Katy Baker Cohen  04:16

I actually don't know the statistics on that. But we do have a really good number of the outlets, at least, you know, we're parents and we're in a totally different field and then came in because we Yeah, with a three bat pathways. I don't I don't know if there's predominantly sorry, pathway one. Meaning like a health professional, I think we do have a pretty good mix.

Emma Pickett  04:39

Okay. And, and the nurse, the nurse work that you do in the community right now. You said you're working with new families. What's the sort of day to day of that work? That's, I guess what we have here is a health visitor. I mean, if I describe what a health visitor resident if that compares, I mean, they're sort of helping parents talk about Sleep and feeding issues and any aspect of parenting? Or are you sort of looking at rashes and worrying about ear infections? What's happening? 

Katy Baker Cohen  05:09

Yeah, it's more on that. So it's a nonprofit. It's not like a given that everyone in the US gets this programme. It's it's a nonprofit, and we're kind of housed under different public health organisations, not necessarily medical. So it's actually not a super medical, it's a lot of education and support. And the end goal really like the heart of the programme is parent child bonding and child development. And it's specifically for first time low income families. So trying to hit like a very time of change, and, you know, potential for growth and support for more vulnerable family. So we do a lot of a lot of education and, and then, you know, practical lactation and bottle feeding and, you know, yes, diaper changing, and you know, what to look for, for a rash, but we're not kind of a medical home visitor, as much of a as a parent support role. 

Emma Pickett  06:02

Right. Okay. Okay. So and that's, that's not necessarily what everyone's gonna be getting experience off in the States. So that's not at all, not at all, current experience. And that's just and that's just a Philadelphia based nonprofit?. 

Katy Baker Cohen  06:16

It's actually what started in Colorado, and it's all over the country kind of sprinkled around whoever whatever nurse decided to start or like health professional decided to apply for funding through the city and federal funding local grants and start a nurse family partnership. It's called and use this model. So it's like a model of I think there actually is one, there starting to be a couple outside of the US, but it's, yeah,

Emma Pickett  06:42

what's it called?

Katy Baker Cohen  06:43

Nurse Family Partnership.

Emma Pickett  06:46

Okay, we have nurse family partnership over here, we call it but maybe we're using that name to mean something else, because we definitely have nurse family partnership models. 

Katy Baker Cohen  06:55

Yeah, I'm not up to date on where they've spread, but their depth. So yeah, it could be yes. Okay. And it's a programme that's super near and dear to my heart. Yeah. 

Emma Pickett  07:04

And you get that you get that continuity. If it's the same model as happens in in the London Yes, programmes that I know, which is so special. So So here here that nurse family partnership work a lot with younger mothers and younger parents and pregnant parents and they, and they'll be with them in pregnancy, all the way through their journey, right up until the child has to, which is an that continue to care is so special. Exactly. Yeah. So someone else funding your lactation consultant training, that's a great place to be for sub for an organisation to recognise the value of that. Yes, to say it's important, and would you like us to pay for you to do it? That's brilliant. I wish that was more common in the UK. 

Katy Baker Cohen  07:45

It's, I feel extremely lucky. Yeah, one of our supervisors was an ibclc. And she was just really passionate and kind of went for funding to help support and so now, in my role, I'm still with that job. And I have my Crescent lactation carers my side private practice, but I'm, we kind of are continuing that within our organisation, we have people who've become ibclc, since my cohort, so yeah,

Emma Pickett  08:07

okay, brilliant. So how much of your week is spent? So the crescent lactation care is your private practice? How much of your week is spent doing that in balance with your nurse family partnership work?

Katy Baker Cohen  08:20

It varies week to week, I don't take insurance, a lot of lactation consultants around me do so I anyway, I provide a super bill I'm a pay out of pocket, I haven't gotten into the insurance world because it's I have a small practice because I have a full time job. So maybe two visits a week, maybe four visits a week, you know, kind of when I can fit it around my other job. 

Emma Pickett  08:41

So you're using words that a little Londoner like me doesn't understand super bill and things like that. So let me let me just clarify. So in America, people can pay to have insurance or their employer pays for them to have insurance. And that insurance can include lactation consultants support and and they speak to they could contact an ibclc and say, I want to see you as part of my insurance. So here's a bit of paperwork that we both have to do to get that visit paid for. And so then the lactation consultant gets money directly from the insurance company. Is that what's happening?

Katy Baker Cohen  09:20

Exactly. It's the lactation consultant can go in network with certain insurance companies. And then if the client has that insurance and the lactation consultants in network with that insurance, then it's yes, the the lactation consultant then has to do the paperwork to get reimbursed directly from insurance and so it leaves the family out of it. And so that's really nice for family so in my case, I'm not in network with it. I haven't applied to be in network with any insurance companies and so I have to give that client a receipt that they submit to insurance and hope to get reimbursed. Okay, under what we call like the Obama Care Obama's or I'm sorry, health care kind of bills, there are laws that insurance should pay for lactation care. But there are lots of it's it's a rocky road, sometimes to get reimbursed,

Emma Pickett  10:12

and the process of getting reimbursed, obviously, for a new parent who's just given birth is quite, presumably quite stressful and waiting to hear. And if they've paid you and it's a while before they get the money back, I guess that's a bit uncertain.

Katy Baker Cohen  10:23

Sometimes it's Yeah, exactly. And sometimes, and so I'm upfront with families and I say, hey, I'll refer to my friend who's a network with you know, I'm, I tried to be very transparent. And honestly, just, I personally am not ready to deal with the paperwork, given that I have a small private practice, but I would go down that road if I was full on in private practice, okay.

Emma Pickett  10:44

Do you think that because people can get their lactation care through health insurance, that means that lactation consultants are kind of valued and seen as valuable healthcare professionals? What's the kind of status of a lactation consultant in America? Would you say on it? It's possible to see it when from the inside when you're in the middle of it, but I'm the reason I'm the reason I'm asking is because in Britain, I think a lot of people don't even know lactation consultants exist. 

Katy Baker Cohen  11:09

Yeah, it is really hard when you're so steeped in it, like of course, everyone should know who we are. But I think we're pretty similar. People definitely don't don't know the difference between an ibclc and a CLC. And all the other, you know, all the other kinds of variations in lactation training that people have. I would say my most My hunch is that a lot of people don't know. And they Google, just like lactation help. And then an ibclc comes up, but they don't know like an ibclc would be the person to look for it necessarily. 

Emma Pickett  11:41

Okay. And then there are some paediatrician offices that might have a lactation consultant attached to them. Is that a common model as well?

Katy Baker Cohen  11:48

Yeah, yeah, we do have some in I'm in Philadelphia, we do have some of that some, we have some nurse practitioners who are ibclcs. And then we have a couple, we have one like lactation clinic where it's, you know, like in, you know, multiple ibclcs in one place. Okay. And we have a birth centre that has a couple of lactation consultants. So yeah, 

Emma Pickett  12:08

so it's not uncommon for a large hospital in the UK, one, you know, a large teaching hospital to not have any IBCs ibclcs on staff. Okay, that would not be uncommon. There would be people who know about lactation, there would be specialist midwives, who might be as part of the members of staff who'd support with lactation. But it's possible for the infant feeding coordinator for a large hospital, and even for a district of the country to not be an ibclc. That's the place we are in the UK. The other guess I guess the other thing to point out in terms of differences is that it's also not uncommon for someone to give birth in the UK and never meet a paediatrician just never meet one. It's just not because they've got no at all ever. So. Okay, so they've not because they've opted out but because it's standard to not meet a paediatrician unless you need very specialised medical care. So some, so somebody might be discharged from hospital or having given birth at home only had contact we really with midwives, and then when they do the checks after birth, it's just gonna it's just gonna be with midwives, or will help visitors who will be coming from a nursing background, they might then see their general practitioner doctor for a check around eight weeks, but they won't see a paediatrician, astounded unless it's felt they need more specialised medical care. Okay. And tell me about your private practice in terms of who you're seeing regularly for seeing sort of two to three clients a week. What's the sort of general mix of people that you tend to see?

Katy Baker Cohen  13:36

Yeah, well, it's very different from my public health job, which is, pretty much all of those families are on Medicaid. So they're on state insurance because of income levels. But with my private practice, you know, largely because I am pay out of pocket, it is a higher income, predominantly white population, where pretty much all my families that I'm seeing for necessarily partnership are black or Latino. And for my private practice, I do offer you know, half price if you do have Medicaid, I try to offer some kind of sliding scale, but it definitely is a higher income, you know, not necessarily first child because anybody's reaching out. And then a lot I have a lot of referrals from doulas or homebirth midwives, you know, that I've created networks with within the Philadelphia area,

Emma Pickett  14:27

and the you mainly seeing I know, with your weaning work, you'll go from be single to children and older babies. But are you saying people within the first few days postnatally what's the sort of typical typical experience? 

Katy Baker Cohen  14:38

Yeah, yeah. I don't know what percentage of my I mean, I so I lead a monthly weaning session. And so that's, you know, my, the bulk of where I'm seeing people who are weaning and then some people will have a private visit with me after that, or some people are just having a private visit. You know, who haven't come to that session, but that's like You know, that's, that's where a lot of my weaning interaction is happening. 

Emma Pickett  15:04

Yeah, yeah, I think, I mean, I found that winning in a group can be great to, to have parents kind of rubbing off each other and doing it. And again, a group session can be really valuable. Tell me a little bit about when you first set that, that group up what led to you setting up that group?

Katy Baker Cohen  15:18

Well, I nursed my son who's now 11 and a half and nursed him until he was about three. And I was, I was born at home, I had my children at home, I have friends anyway, I was in kind of like, very, you know, natural birth community. But in terms of lactation, no one, not many people I knew nurse pass one, or you know, very far and I had this I think my mom nursed me until I was one but and then my sister a little bit, not as long. And so I had this like, I'll never walk, I'll never nurse a kid that can walk up to me and ask for it. That was what I said. And so then with my son, I didn't have so much like existential whatever thoughts about it. We just kept nursing but I had gone back to work full time. So I was one of those like, nurses asleep. We've mostly bed shared nurse to sleep nurse on the weekend for nap, you know, by the time he was, you know, to like in those older toddler quote, unquote, older toddler years, and he was a thumb sucker, so it just kind of, you know, one night he turned over and sucked his thumb instead of nursing. So it's just like a pretty smooth, I didn't think a lot about weaning with him. I didn't feel a lot of pressure. I don't know, I honestly it's kind of a blurry, you know, blurry time, first time there in time. 

Emma Pickett  16:38

And child led weaning is often blurry. So if it was led by him, it's funny how you look talk back to someone they're like, I don't know how waiting happened. I don't even know how long it took. I don't even know when he didn't want to feed or to feed. So yeah, it's just it's simple like that. But that word blurry feels very familiar. Because it is just just incorporated into daily life. And you're not consciously aware of, of when those shifts happen, especially if you're working. Just actually just a word about before we talk a bit more about your own experience of breastfeeding, that the idea of going back to work. I think the American experience is very different from the British experience in that. Yeah, it's it's really uncommon for someone to go back to work, you know, under a month or under two months, but I am hearing stories of American breastfeeding parents returning to work, you know, under two months. Yeah, the six weeks. Yeah, that's, that's not common for someone to go back to work. It happens very occasionally. But it's not common to someone to go back to work at six weeks in Britain. So you're dealing with people who are trying to make lactation work, knowing that they're gonna go back to work, you know, within a few weeks, I'm guessing you're having different conversations that I'm not having. And you don't even know you're having these different conversations. Yeah, yeah. Are you talking to people who are saying, I've just finished bleeding from, you know, from my giving birth, and I'm literally returning to work while I'm still bleeding while I'm still in pain before breastfeeding is being established? What kind of conversations are you having around that early return to work and lactation? 

Katy Baker Cohen  18:06

Yeah. And I think it differs depending on again, like Job Status, status and income level and you know, what your your maternity parental leave is, but it's definitely it's something that's already looming, I think, you know, they're learning to latch, they're getting into the routine of, you know, a baby feeding routine. And there's always already that like, looming, how's this going to work? Should I start, you know, how do I should start pumping, I should start doing a stash all of those things. And definitely for my families that I support that have kind of fast food restaurant jobs on call on call nursing home jobs, you know, it's just like, it's already disrupting before things can even get established. I feel like that's very disruptive. And I, of course, tried to say, you know, if we can establish things really solidly, even in these first two weeks, like not start changing things, because you have work coming so soon, you know, ideally, but I think the anxiety is there, it's hard to like, ignore that looming change.

Emma Pickett  19:10

Yeah. And, and in the States, you have protected rights to express milk in the workplace that we don't have in the UK. So you have, you have the federal law that talks about, you know, sensible work breaks, I can't remember the word, the particular word is and then you've got additional state law on top of that, which often gives additional protection. If somebody let's imagine someone's going back to a fast food job, they would have breaks to express at work, and they would expect to have that or that's not really happening in practice. 

Katy Baker Cohen  19:38

It's funny, we literally just had a few nurses and I just had a kind of in service chat, live exactly about this, especially for some of the new nurses just trying to really make sure that they were supporting and setting up for their clients for success as much as possible. And we just all kind of came to a point of shrugging our shoulders of this is super hard, like if you're taking public transportation arriving at a fast food job, and you're maybe 17 or 18, or 19. And your boss doesn't know about lactation, all I'm all that to say, yes, the laws in place. And the reality is not that they're like, Okay, it's been three hours, you should go take a half an hour to pump, you know, at all. Okay, so we have a lot of people switching over to Formula bottles are because they can't keep the production going. So yeah, the law is there, but the translating into reality in these jobs that are way less secure is super hard. 

Emma Pickett  20:33

Yep. So that federal law that talks about reasonable breaks means nothing if your boss is just not someone who said, 

Katy Baker Cohen  20:39

Yeah, and if you don't feel empowered, and you just came back from maternity leave and hope hoping you can even keep your job or didn't, you know, or you were kind of, we have a lot of these jobs that like, Oh, I'll know my schedule next week, like you get your schedule each week. So you don't even know when you're going to be working kind of thing. Yeah. That's super tricky. 

Emma Pickett  20:57

Yeah. But despite this, breastfeeding rates are higher in the States than they are in the UK. Almost every measure, I think our initiation, birth might be slightly higher, but our drop off is massive. So we have lower breastfeeding rates, that four weeks, six weeks, six months, despite the fact that that you guys have got lack of paid maternity leave. And it's the, you know, the breastfeeding breaks. law isn't necessarily making a big difference because particularly families with low income jobs. Yeah, you still have high breastfeeding rates. So what's what's going on? Katie, I don't expect you to have the answer. But why do you think breastfeeding? And breast milk is more valued in the States? What's happening? Do you think? 

Katy Baker Cohen  21:40

I'm, this is a stumper for me. I'm not good. I don't I because I don't know. I I don't know how to answer that.

Emma Pickett  21:46

I don't know. If you if you did, you'd probably probably be able to create public health legislation and change the world.

Katy Baker Cohen  21:54

With Nurse Family Partnership, and I wish I had written down stats, I'm really bad. But our initiation rates are even higher than, you know, the state initiation rates, which just points to support support support, like we know that, you know, if you have support, it's a huge help. And I would say 98% of the families that support the parent wants to try to latch so we definitely have like our initial like, there's not, there's not many people are like no, I don't want to do that at all. So I think that just points to like, the intention is there. People know it's healthy. You know, we don't need to go over that. It's more the house is going to work in your daily life. So I think it can be helpful to more people we have to talk about that with is definitely helpful.

Emma Pickett  22:38

Yeah, gosh, I wish I knew the answer because we have Yeah, we definitely don't have 98% initiation and your and your population that you're talking about the you know, the everybody who's who's getting access to this family partnership, not just people who want to like date. Yeah, and I don't know if we have 90,

Katy Baker Cohen  22:53

we definitely have 98% intention. And this is not on the books number I'm spouting out but like 80s Definitely 80s initiation.

Emma Pickett  23:02

So in the UK, we do have a slight correlation between lower income families doing less breastfeeding initiation than higher income families and and the lower income families are more likely to initiate with formula feeding. Yeah, yeah, we're not we're not the macro population statistics people here. We need someone else to come along. But there's something going on. I don't know whether it's the hospital county when someone's giving birth at a hospital will they be getting good quality lactation support in the first couple of days there?

Katy Baker Cohen  23:33

So at least in Philadelphia, almost or all of our of our hospitals are baby friendly. Meaning there yes, there is lactation support, you know, I just had someone leave and need lactation consultant wasn't able to make it in until you know, the hour before she was leaving. It's not a perfect system if someone's off shift or whatever, you know, but there is lactation support and all our Philadelphia hospitals. 

Emma Pickett  23:57

Okay. So we can have baby friendly status in the UK and not have an ibclc. Okay, yeah, it'll just mean it'll just mean that the staff have done training and policies are in place. 

Emma Pickett  24:12

A little advert just to say that you can buy my four books online. You've Got It In You, a positive guide to breastfeeding is 99p as an e book, and that's aimed at expectant and new parents. The Breast Book published by Pinter Martin 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 my last two books are 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 MMPE10, Makes Milk Pickett Emma 10. Thanks. 

Emma Pickett  24:58

Let's talk a bit more about your experience. So your son was waiting around three, three years old and sort of doing his own thing and drifting away from breastfeeding. What happened after that?

Katy Baker Cohen  25:08

so I became, I was pregnant with my daughter, like, couple months after that. And then so, again, we we nursed along. And it's, I don't know what the difference was, I think the difference is a different kid. And, you know, I had the same job, the same kind of routine, same child care, everything, and same routine in and nursing to sleep nursing, kind of on demand on the weekends, or when I was around her. And I don't know, I think she just asked for it a lot more than my son, you know, when I was cooking dinner, or different things like that was very much more public about it and vocal about it, she's still, you know, she is seven and a half now. And still, like, loves to talk about my breasts and say hi to them in the morning, and all of these things that I never thought I would, you know, be at this point, but I no timeline because it was leading up to the pandemic. So she, I guess, I just started having this idea of like, three years old, we should stop, because that's when my son stopped. So I started putting this pressure, you know, and just having all these conflicting thoughts, kind of making fun of myself for keeping going, you know, kind of being a little bit disparaging of, you know, I don't have any willpower, all these things that like, you know, go through our brains. So I had made a date, you know, International Women's Day, April 2020, I was going to have we did, we had a ice cream cake and all of this stuff and had a celebration, and had like our quote, unquote, last nurse to sleep. And I was still snuggling her and nursing and nursing to sleep and laying with her every night. And then yeah, it was locked down, and I was tired. And she asked a nurse at the end of the day, every you know, every night, and so we went back to nursing to sleep for the rest, you know, for the rest of that year, and finally had our last nurse around a year later. So she was almost five, she was like a couple months short of five, when we had our last nurse, all of that to say that is what got me thinking like, I'm kind of I felt a little alone in my thoughts. I was ibclc and nurse, super empowered, like should that should have been like, Yes, I'm nursing as long as I want. And that's what it is. And we're doing, you know, whatever we want to do. And just realise there wasn't a lot of areas to like, talk that through or have support with other families. And so this idea for these monthly sessions, which I called Turning leaves, kind of a, you know, a joke on like, you're turning a new chapter turning a page kind of thing. And I don't know how I stumbled across Amy browns, why breastfeeding grief and trauma matter book. But I read that kind of to inform myself and get ready to leave these sessions. And I had this idea that we would do some writing prompts kind of like group journaling time, you know. So her book was super helpful. I think what I my intention, and what's kind of what I've seen from the groups is that people just want a space to talk through what they've been through and kind of have a space to talk through all the thoughts that are just jumble in your head while you're walking around as a parent.

Emma Pickett  28:09

Yep. So so the groups then do you have a site the same group of people for several weeks in a row? How do you structure things?

Katy Baker Cohen  28:17

No, I would I know that you do that. And I love that model. I do have a WhatsApp group for anyone who's joined the session, but it's just a very loose, so no, you can sign up and then you come and then once you've come once you're I send you the link for any for all the groups until you tell me, okay, that you're no longer wanting the lake. So you're always welcome back. But it's kind of I use the same write the same structure. And the same writing prompts. Every group with a little variation, if someone's already been there, like I give them an alternative writing prompt if they want something different. But sometimes they use the same writing prompt because they're at a different stage.

Emma Pickett  28:55

So it sounds as though it's it's very flexible. And sometimes you might have three people and sometimes you might have 13 people I mean, it can vary that much. 

Katy Baker Cohen  29:03

Exactly. I think I've had a max of eight. I'm wondering about, like putting a cap because then I do have people share out from their writing at each point. It's just like three minute little writing prompts, and then we have time to share. 

Emma Pickett  29:16

Yeah, that's a great idea. I love the idea of the writing prompts. Yeah, so the WhatsApp groups that I do. I'm not actually currently doing one right at the minute because my daughter is doing exams, but I we meet every week. And it's usually for about six weeks. But I have on occasion taken a group a bit longer because they were in a place where that needed to happen. And then we have WhatsApp chat throughout the week going alongside that. And I had one group that was just for people who were pregnant and thinking about putting breastfeeding boundaries in place. And one group where people were currently tandem feeding and wanting to put breastfeeding boundaries in place. And then most of them are people who are thinking about bringing breastfeeding to an end or reflecting on bringing breastfeeding to an end. And I've had I've had a group where nobody ended up waiting. Yeah, and that's not my goal. but not my goal by any means at all. But everyone came thinking, oh, yeah, I really need to learn about weaning, or this is something I really need to do. And nobody had weaned at the end, because they'd all come to a place of realising that they could make changes, they could make shifts, they could protect themselves and their breastfeeding relationship. They could communicate with John different way, they could feel more empowerment and carry on breastfeeding. Yeah, I've had people who've gone on for the two or three years, I've got I've still got the WhatsApp groups going. And I've literally seen people night weaning now who are coming to my weaning group and in 2021. So either I don't know what exactly I can do, how can explain that, but they, you know, they they felt okay, about not breastfeeding, sorry, by still breastfeeding and not weaning at the end of the group. So it sounds as though that's similar in your space as well, that it's a place for reflection, it's not necessarily a place for tell me how to stop breastfeeding. Give me the facts, give me the information.

Katy Baker Cohen  30:52

Exactly. And I've found the same thing that it's actually people have this sigh of relief at the end of the session, like, okay, I guess I don't need to do anything about what we're doing. I think I'm actually okay with what we're doing right now. Which also wasn't my I didn't have like an ulterior motive. I want you to keep nursing the situation going on. But I definitely think that, like, totally what I experienced, it's just more it's more noise in your head than actual reality of what you're feeling with your kid. And so I think it's very empowering for people to hear from other people, even if they're in different stages, just like, oh, we all don't have this exactly figured out. And there's a lot of complication. But when it comes down to it, we're probably making it more complicated in our head than we need to.

Emma Pickett  31:36

Yeah, yeah. No, I think that's true. I think that that phrase, external noise, I think is really useful. I've had a couple of people coming to my groups who their child has turned to, and this is what they thought they should do. Because surely children don't breastfeed beyond to and ready to actually talk to them. They're completely happy about still breastfeeding, their child is completely happy. It's absolutely working for them. People are sleeping fine. It's all good. They just thought, theoretically, this is what they should be doing. And actually, when they talk to other people, and some people, the group might be feeding a three year old or three and a half year old. I've actually had one case someone literally came for one session, I was like, oh, okay, I'll just carry on that. That's cool. Thanks. They probably just realised it was fine. And no one was thinking it was a problem. And it really wasn't a problem. I think sometimes those people are coming because they're getting external pressure. And yes, some partners and other people would do, how do you help people have that conversation? If somebody is getting pressure from perhaps a partner, and they don't want to end breastfeeding? How do you help people have that conversation? 

Katy Baker Cohen  32:41

Yeah, I think the pressure to partner was really hard. And I don't you know, I think in it's, it's a funny thing with the groups, you know, we're not really diving. It's kind of I give it little, you know, a talk on what I had learned from why breastfeeding grief and trauma matter, and that it's important to have this space to process anything along your feeding journey. But I'm trying to think back to consults about having that specific discussion. But again, I think I think one thing that's helpful, and I just have to have a lot of trust in the groups, because yeah, we don't solve anything in the group, there's a lot of like the writing process, and then we share, and then you just kind of sit with what you felt during the group and knowing you know, that you had time to think. So I think just having a moment to shut out those other voices and tune into what you and your kid need. And that sometimes the partner is putting pressure because again, they think that that's the right thing to do not because it's actually a problem, you know, for the family, and maybe helping the parent who is nursing communicate that, you know, maybe you're trying to help me, but actually, this is going okay for me right now, or I really do need your help in this other area.

Emma Pickett  33:49

And don't assume that anything, breastfeeding is the way to solve that. Yeah, just kind of delving a little more into it. Yeah. So I'm tired. I'd like to sleep a bit more. And the answer is not necessarily ending breastfeeding. Maybe you could get up on the weekend, etc. Yeah, yes. Yeah. Yeah, I mean, that that part of the conversation is so difficult because it can often when someone's breastfeeding, older child, they can feel very isolated. And if they feel a sense of criticism, it's so quick to You're so quick to kind of panic and adrenaline's rushing, and you start to get defensive and you start to really worry that you're in a place that you can't fix at all. I sometimes see on social media, somebody says, Oh, my partner made this throwaway comment and everyone else is piling it Oh, leave him red flag. You know, don't hang around. Oh, god. Yeah, run as fast as you can. It's like hang on. Yeah, let's let's try and be really mature about this. Let's try and get put ourselves in the shoes of let's say a husband, who went back to work at two weeks knows nobody else who breastfeeds let alone someone still breastfeeding. A two year old is worried about what's outside. society's perception is worried about their sex life is worried about their parent, you know, their partner being tired, you know, just doesn't know what happens next doesn't know how it ends, and wants to try and get control over something they don't fully understand. We have to try really hard, I think not to jump into panic mode and to try and, you know, we're so strong on wanting to make sure women are not under pressure from men, that women have agency over their bodies. And it's totally understandable that we would jump to not okay, really no, but we're angry about this. But before we get angry, I think we have to just take a moment to say, Hang on. This bloke may literally know nobody else who's ever breastfed for this length of time, and is just really frightened and confused. Yeah, you know, can we empathise and get to a space where then they're calmer? So then they can listen to us? And have us explain why breastfeeding matters to us and why it's important to us and why it's valuable. And an often if you can just get calm for a moment. And everyone calm for a moment, because it's often in the arguments that someone's going to lash out go, Well, we haven't had sex for six months, because you're bloody breastfeeding. Right. And that's not the moment to talk about breastfeeding. It's the time to talk about it as you know, in another space, but if we can, I think we sometimes do need to empathise a bit more with the people who are struggling. You know, when the mother, like someone's mother in law, or their own mother makes a negative comment about breastfeeding. You'll know from reading Amy's book, how much grief and trauma can hang around for decades, if someone's breastfeeding, and it's not going well. You know, that negative comment when someone says, Oh, my God, I can't believe you're so breastfeeding, that three year old is often going to come from their own grief around their own breastfeeding journey and, and seeing you make a different choice that then triggers their feelings about their own choice. And I think we just have to try really hard to empathise with where these negative comments are coming from before we jump into being in defensive mode. Yeah, easier said than done when we're also feeling tired and stressed ourselves. But we're not going to be able to move forward if we if we see it as battle lines being drawn, and we see it as conflict. You know, people are the product of their cultures. And if you're living in a culture where breastfeeding beyond infancy is not normal, it's really hard to resist that for everybody. It's a difficult space to be in. Tell me about some of your weaning consultations that you have kind of one to one, if you're supporting somebody under 12 months? Is that a conversation that happens fairly regularly? What are some of the sort of key things that you want to talk about in those conversations?

Katy Baker Cohen  37:29

I think they happen if like if you know, nursing has gone okay, up until 910 months, I feel like people are often gearing up to wean at one year again, because they're like, this is what we should do switch to whole milk and stick it in a cup or you know, whatever it is like that. That message is super strong, at least here in the US that like that's what you do at a year, even despite, you know, nursing going well, and the American Academy of Paediatrics and you know who and everybody else saying to nurse till two. So sometimes it's like a theoretical Howard like question kind of, like we were saying, for the weaning group where they think this is what they should do. But, you know, if we talk it out a little more, and kind of like, unveil the magic thing of like, actually, on the kids one birthday, you know, first birthday, nothing, nothing crazy is gonna happen, you're actually just going to continue on. So that's one conversation. And, you know, some people still want to kind of wind it down around that time anyway, or definitely drop a pump session around, you know, one, if they're still nursing, a pumping at work. So that can be really nice. With a lot of the families I support through my public health job again, it's it's stuff, you know, it's like, needing the freedom of other family members being able to watch the kid or the flexible, you know, or the crazy job schedules or going back to school. And so it's just kind of happening because of necessity. And then, you know, we do talk about, you know, if you did two pumps sessions a day and they got that breast milk that that's totally fine.

Emma Pickett  39:01

So a lot of practical stuff. And then when people are going back to work fairly early on, I'm guessing there's not so much co sleeping and feeding through the night people are probably night weaning a bit sooner than they might if they weren't going back to work. 

Katy Baker Cohen  39:16

It's such a messy one because I think we don't always even get to what is happening. Sometimes I even if I asked, you know the reality of what's happening, but the messaging about not co sleeping is super strong here. Okay, yeah, very strong. And, you know, a paediatric visit. A typical paediatric visit is like, how are you? How are you sleeping and people kind of, I mean, we even talk about it. You know, people in the medical field lie to their paediatrician about how they're sleeping just because they don't want to go down that road. So it's kind of how are you sleeping? Yeah, on baby's back in a in a separate thing. Okay, cool. And then moving on. So that's like a typical, I'm sorry to badmouth paediatricians, but that's like a typical health visit. So we do have to do a tonne of education like is being really sensitive and careful. And I think a lot of healthcare providers feel scared to have the conversation because they don't want to come across as being negligent or suggesting something that's dangerous, if they are even talking about that sharing, but luckily, you know, we have James McKenna's book and you know, the ledger league safe, you know, safe, sleep seven, and all of those. So I do feel confident to talk about that in my public health job and my private practice about safe bed sharing.

Emma Pickett  40:26

Yeah, we've had a bit of a transformation in the UK in the last decade or so. So 10 years ago, people were still telling people not to Bed Chair, and then the nice guidance. So we were governed by guidance that's created from you know, research etc. And good practice. The current guidance that governs the NHS practice says that parents will be co sleeping, and conversations should be happening and around that. And although the safest place maybe a separate space in the same room for the first six months, people will badger and we're referring a lot to the University of Durham, Helen balls work at the University of Durham and and fro similar to the messages that James McKenna is coming out with around normal breasts, sleeping and normal sleeping patterns. And we know that three quarters of families are going to be bed sharing, so to tell someone not to do it just simply means they do it in secret, and it's just exactly and it's more unsafe, and simply makes no logical sense. Okay, I'm gonna put you on the spot a little bit here. Let's imagine you're talking to a parent of a three year old, and a three year old is co sleeping and breastfeeding through the night. And they come to you and say, Katie, I want some help tonight. When tonight when my three year old, what are some of your sort of favourite go twos for that conversation? And how do you often have that conversation with parents? 

Katy Baker Cohen  41:40

Yeah, this is the super hard. I mean, I used to my default used to be, oh, my gosh, and I'm blanking on his name, Jacob. That was kind of like my go to, which is, you know, choose the time of night and kind of start to use that chunk of time to cuddle or soothe in another way. And gradually, like, you know, stretch that time out. And of course, we talked about that that's you're then going to lose sleep, because you're going to be spending more time you know, shooting your kid than nursing right back to sleep. So I don't know if I, I have no numbers on what works or if that but I don't have a strong sense. There are people like, Okay, did that. And that was awesome. I do think it's like a tangible starting place, at least for people in their brain and feels a lot less overwhelming. So whether or not it worked, at least it's like an inroad to like, how do we it? Because, yeah, it can feel totally like you're at an impasse, because this is all you've done for the last three years. And so, yeah, I think that that's a nice entry way. And then I definitely just, I think it blows most people's minds just to think about a little bit of flexibility and musical beds in terms of like rethinking that there doesn't have to be this linear, you know, I mean, so they go in the other room, and they sleep in their own bed, and it's all like clean and tidy. So dragging a mattress onto the parents floor, or dragging a different mattress into the kid's bed, so that the parent can lay down and soothe their kid and not nurse or just have other sleeping spaces to do different things.

Emma Pickett  43:10

I'm a big fan of the floor bed, I think the floor bed is so handy, because if someone's been going into a room with a crib, I'm using the American word that crib, we take heart, if someone's going into Rome with a cart, breastfeeding a child back to sleep, putting them back in the car to sleep, and then creeping back off again, how the hell do you stop doing that? That's, that's so hard. So I'm definitely that situation, a huge fan of the floor bed and bringing the child to the floor bed and cuddling them and settling in that way. Talking about Jay Gordon, for a minute, that article, I was really surprised to see that he's brought the Age down to 12 months. That article is historically always used to say, and let's talk about a child, he's 18 months old, they've spent 18 months in the family bed, that you know, they've had all this lovely 18 months of co sleeping and breastfeeding, they're going to be absolutely ready. Now. If you if you need to do it, let me know I'm going to give you information to help you out. He's gone down to 12 months and that article he knows that you could not wait 12 months old, which I was quite shocked about because he's definitely comes from an attachment parenting background. And I personally feel there are quite a few 12 month olds who may even nutritionally need milk at night. Yeah, and may not yet have been taken, you know, taken on solid solids very effectively. So it was quite surprised to see that. I think what's interesting about that J Gordon article is it just it's a good talking point. So it's a good right it's a good article to say let's let's sit down as this is one man, let's let's see what he says. And one of the things he does does say is it's okay to think about yourself, it's okay to want to want to sleep and it's you know, your child may not be thrilled about it and it's not their choice and they may want to continue feeding at night that you're allowed to look after yourself. I think that's the one of the nice messages of the article. One of the things that I say about that article is it's okay to slow down a little bit. So I have Use that article, if someone has to win very fast, so maybe they've got stuck with chemotherapy or something, I've used that article. But he's quite quick to move from three nights when you don't nurse to sleep, then three nights where you don't nurse at all, then three nights where you're going to de escalate their intervention. And I sometimes say actually, it's okay to slow down a little bit. Yeah, and yeah, take take a bit more time to upskill yourself to develop your own methods of what you're going to do after you're fed before you then don't feed entirely. I say ideally, maybe the child is accepting coming off the breast, accepting moving to the other comfort methods before you don't breastfeed at all. And it's okay, it's okay for it to take a little bit longer. I'm quite a fan of what Lindsey Hookway calls habit stacking. So yeah, the other thing that that the J Gordon article doesn't allow for is taking some time to introduce those new methods before the breastfeeding is kind of pulled out. So I'm quite a fan of, of layering on something else first. Now, that may not be easy at three o'clock in the morning, it may be something you know, you need to think about what it feels it feels realistic. But you layer something on first to give them that kind of muscle memory of this is what happens when I fall asleep before you start taking the breastfeeding out. I think the J Gordon method, if you follow it to the letter does mean qualities it is it is there is going to be quite a lot of crying. And and that's not always completely avoidable. I think even if you're going very, very gently, I think a three year old might still be extremely angry about nightwave. The fourth night when they suddenly go hang on, what the heck are you sticking with this because if you are I'm going to be across about this. And it's that isn't something that we should necessarily perceive as a failure. You know, our job is to hold that space and to validate those emotions and support them through it. If someone comes to you and says, I want to win my child, and I want no tears, I don't want any crying. I don't want any crying at all. Is there a no cry method? How do you answer that question?

Katy Baker Cohen  46:57

I think that's virtually impossible. And maybe there's something to be depends on your kid and their age. And you know, there might be not, you know, maybe you can avoid tears, but you're definitely not going to avoid some kind of pushback from your child. Otherwise, maybe they would be weaning themselves or something, you know, otherwise, you wouldn't be asking me that question. And I think like to back up for my answer before, before I would even start obviously, you know, going right into a method or a solution for beds, again, kind of getting back to what we were talking about just asking the parent about their motivation. Just knowing from my own experience, if you're just like doing it, because you think you should be doing it, then it's gonna be a lot harder to like, help your child through those hard emotions in the middle of the night. Versus I think I'm always excited when a parent comes in, they're like, I'm not sleeping well, I'm so ready to like, not be touched at night, or just something very concrete and clear, because at least then we have like a really good starting point. And you can have that in your head while you're cuddling your kid. You know, I know my body needs this, like telling yourself that over and over. So I guess Yeah, if someone said they didn't want any tears, I would just kind of reframe the situation we're working with and kind of validate like, This is all your kid has known. And when something changes, it's just sad, a little sad. And like, both people are going to have emotions. It doesn't mean it's not the right thing to do. And it's like parenting in any other area. I forget who was speaking at a gold conference last year that a gold lactation conference, and she was doing a weaning talk. And I mean, this is obvious, but it is a changing relation. Like you're not, especially for the older kids. It's not so much a nutrition, there is nutrition. But a huge part of it is that you are changing a relationship and when a relationship changes, that's just that's just emotional period.

Emma Pickett  48:49

So yeah, sorry. Faulkner. I think he was talking about winning a Golden Yeah, but yeah, yeah. I mean, yeah, yeah, I think that's really key, isn't it? We there are two people in this relationship, this relationship is shifting, and both people's set of emotions are valid. And one of the things I sometimes say is we can't win by stealth, we can't win by particularly the other person's not going to have feelings are going to have emotions or tiptoe away and hope they don't notice, which is why I'm really not a fan of people trying to win by literally leaving their child with somebody else. You know, children have the right to react just as we have the right to when breastfeeding. I think when sometimes when a parent says I really want to do no tears, they're feeling guilty about weaning, they haven't yet given themselves permission to care for themselves. They haven't really got to that place of saying I am allowed to do this. I am allowed to do this for me and I am allowed to care about myself in this space. And yes, it's not what my child wants, but I'm going to be a better parent if I move forward with this and this is what I need to do and I on one level wish I didn't have to do this but I know I need to do it. And this is almost a gift to my future self you know myself in six months time. Yes, looking I'd be right now saying, Please do this for me, I need you to do it, it's not going to be easy. It's going to be hard. There'll be moments when you feel wobbly. But I need you to do this for me, what you were saying a moment ago, really rang true that idea about if someone's not got those concrete motivations, if they're doing it for sort of theoretical theoretical reasons, they're going to be the people who are really struggling it to a yeah, they are really having a tough time, if you're doing it, because your mum has told you, you should be weaning, and you've got a sobbing toddler next to you, and you're not able to co regulate, because you're feeling a bit wobbly yourself, you are not just you still go to work, it's just not going to happen, you're not going to be able to have and hold a safe space for that child. But if you've processed your feelings, if you've given yourself permission to Wayne, if you know it's what you want to do. If you've talked to someone else, if you're really solid, this is where you need to go, then you'll have that calm, regulated state, which then means you're able to co regulate your child support them through it, give yourself permission to move through it. So I think a lot of wedding support does need to be talking to a parent about is this really what you want, as you say, talk about your goals? Why? Why do you want to do this? What's the end goal? Is it 12 hour asleep? Well, you've got an 18 month old that may not be. So let's talk about normal sleep patterns. Let's talk about what we can do to maximise our rested. You are, you know, if you're doing it, because you absolutely you know, want to get pregnant again and your periods not returning. And you want to night when for that reason, great. Let's talk about maybe getting a block of six hours, it doesn't necessarily have to be a full night. There's so many plates or places to have this conversation before we necessarily jump straight into full weaning. But I think that one of the key things about waiting support is it's got there's got to be a big discussion first about where you want to go, what you want to do, rather than launching into up give a bottle of this feed, drop this feed, drop that feed. And sometimes people are just giving up, you know, giving links to articles without actually taking time to really talk to someone about what their motivations are. Do you have any particular tips for weaning sort of older children who are very emotionally attached to the bras to her? What I call booby monsters? What are some of your sort of favourite tips for those families?

Katy Baker Cohen  52:07

Yeah, that's I think, going again, making sure that your motivations are very strong within yourself. And I think being clear. I mean, I've learned a tonne from you saying the dollar off, you know that the don't offer Don't refuse method is not a great, you know, great saying because you're gonna get stuck nursing on the couch all day otherwise, or you know, then you're just kind of

Emma Pickett  52:30

I've had some real pushback, pushback for that. Katie, I have to say I mentioned it. Oh, and I think I mentioned it in my gold talk to two years ago. And some somebody was really not happy with me. I think she maybe was a little league veteran. And she was very angry, I think. So for anyone who doesn't know or hasn't read my book wasn't familiar with it. That phrase don't offer Don't refuse, has historically been seen as a weaning technique. And so we're being we're telling parents don't offer the breast but don't refuse if someone's asking you for breastfeed. And the idea that that's a weaning technique absolutely infuriates me, because I think it's so dismissive of the parents and the parents body. Because don't refuse. I mean, I don't think people realise for two year old who's a Baby Monster, they can literally be asking every 15 to 20 minutes. Yeah. I mean, does that mean this parent can't cook? Does that mean they can't, they can't work, they can't have a shower. I mean, it's just physically impossible for some people who are so overwhelmed by their breastfeeding. And don't offer I also find a bit infuriating, because there may be times when you want to have agency over the breastfeeding process, then you might say, right, sweetie, we can have a breastfeed now, because mommy's not cooking. I don't have to go and pick someone up from nursery. So I really think, don't offer Don't refuse is not allowing parents to have agency over the process. And it's actually it's essentially self weaning, which is, it's not right for everybody. Not everybody can practice child led weaning and to protect, pretend that don't offer Don't refuse is anything other than self weaning, I think is, is almost dishonest. I don't think I don't think we should be promoting it as a winning method. It's just a way to describe self weaning. And some parents really do have to practice parent led weaning, they are really struggling this, they have to do differently, they have to stop medical treatment, or whatever it might be they some parents do have to stop breastfeeding. And then if we don't get the information about how to do that in a way that respects their relationship, they will end up abandoning their child for four days, or, you know, putting weird stuff on the nipples. It just really makes me really makes me cross. So thank you for reading my words or don't offer Don't refuse and thank you for thinking

Katy Baker Cohen  54:36

totally transformative for me and how I was guiding people with. Yeah, I mean, it's a whole parenting relationship. And I think some people are saying that because they're like, you know, I am attachment parenting. That's what I've decided to do since my kid was born. And so I'm not going to like change that now. Because that would be like, quote, unquote, the wrong thing to do and then attachment parenting. And so kind of reframing that and just Talking about basic attachment theory and that you know, you are at your child's safe base. And actually a kid does appreciate a parent who's clear on what they want. So I think one thing with the, yeah, that the toddler who's asking constantly, just to, and obviously, it is easier to dish out this information than to do it myself because I feel like it applies to like, every, I'm like laughing at myself with my seven and 11 year old, you know, like, they want clarity and clear guidelines. Like that calms children and so, so just yeah, the more clear you can get in yourself. And then the more clear you can get with your toddler about, you know, when it's no, it's no and being super firm on I love you so much. And I can hug you and give you a huge hug. And I really love you and come be by my side. I love you. I love you, you know, like, yeah, like the refuse is not an adult love you. And there's not a lot of other areas of parenting where you would say don't refer like to your point where you would say don't refuse. 

Emma Pickett  56:03

Refuse is such an awful word as well...

Katy Baker Cohen  56:04

like you're there to create the boundaries, that is your job as a parent. So again, I think a lot of a lot of the weaning stuff is not really like, this is how you reduce breast milk, or I mean, obviously, unless it's a before one and we need to make sure we're replacing nutrients, but it's like a lot of parenting. Parenting guidance. I'm not I don't I do not consider myself a parenting expert, but like parenting working through your, your worries and guilt and that kind of thing. 

Emma Pickett  56:35

Yeah, yeah. I mean, a lot of the wedding stuff is, as you say, worrying about mastitis and firm breasts, rather than thinking about the emotional side of things. Yeah, that's just just bananas. I've been thinking about, you know, what Attachment Parenting really is, I, I think you're right that some people, especially in the world of social media, right, say, Okay, I'm this kind of parent, this is my identity. So this is how I, this is how I feel about this. And that this, and this is how I support my child to feel empowered. And these are all the things I do. And sometimes it's easy to lose sight of the fact that actually Attachment Parenting is really about authentic, emotionally real parenting, it's about creating little people who have an emotional vocabulary, who are emotionally intelligent, who value their whole range of feelings, you know, and then they're going to be teenagers that value their whole range of feelings. And you're creating an environment at home, which is emotionally healthy, which for some of us means breaking cycles from, you know, the 20th century that weren't so healthy. So if you are self sacrificing and forcing yourself to continue breastfeeding, when you don't want to, that has a negative impact on that authenticity of your relationship with your child and your child can pick up on that they'll pick up on your micro expressions, they'll pick up on your body language, you know, people who are gritting their teeth experiencing breastfeeding aversion and feeling that they have to continue through that are potentially going to be damaging their relationship with their child much more significantly than if they said to them, right, listen, my beautiful, lovely child, I cannot do as many babies as you want to do. So we're gonna have to work out a way that we can do fewer babies, and I'm gonna still love you, and I'm still gonna play with you. And we're gonna do all these special things. But boobies are tired. Yeah. To say boobies are tired, is not betraying the course of attachment parenting, it is being authentic and real. And it's actually creating a world where children, you know, will hopefully grow up with that more real emotional conversation with you and be able to understand empathy, because that's what we want. We want little people to understand empathy so they can regulate going forward themselves. But don't offer Don't refuse is the opposite to that.

Katy Baker Cohen  58:42

Yep. I like another, where you are going with the like, gritting your teeth and nursing moments, Xena beats when breastfeeding sucks. But yes, yeah, it was super helpful, because I just loved she just gave me some practical things. But that's a book in which she talks about a version which is not necessarily you don't have to be a nursing a three year old to have a version, you could have a version at any point in your breastfeeding relationship, but I think it translates really well. And she really can't translate can translate well to the weaning process or when you're starting to feel touched out. But your baby's still wanting to nurse or your kid is still wanting to nurse. And something that really like I that that I find myself saying to parents is if you're able to say no before you're granted, before you're gritting your teeth, and feeling touched out, then you'll have an easier time of saying no, because you're a little more regulated. So basically like yeah, setting the boundary before you're really angry at your kid. So I thought that was really like a translatable thing from her book, even if you're not experiencing full on, you know, body aversion.

Emma Pickett  59:47

Yeah, I think so. I think it's important to stress that some people who experience a version do not want to win and are years away from weaning and will continue breastfeeding through their version but I think you're right that sometimes when people are in that space of experience Like aversion or just simply not wanting to breastfeed, we're trying to put boundaries in place before we get to the desperate place. Because when we're in the physically desperate place of literally gritting our teeth, of even a very young nursling can pick up on that vibe. And we get into the cycle that if you've seen this with your clients, where they're asking again, and they're asking again, just at the moment, when you're finding breastfeeding the hardest, you're getting more requests. Because your child, your child is noticing that you're struggling and they're looking for confirmation that you're okay and that the relationships Okay, and they're picking up on that insecurity. And they ask even more grows, if you if you actually get to a place of saying, write my love, we do three boobies between lunchtime and bedtime. That's all we're going to do. And you know, once you've put some boundaries in place, and the breastfeeding that you do do becomes more positive, you may find that the requests just drop away. And they ask a lot, a lot less because they're not picking up on your sense of desperation. You're mentioning lots of British authors. Katie, I'm very proud that you're mentioning.

Katy Baker Cohen  1:01:03

You guys have the US as the winning thing overseas.

Emma Pickett  1:01:06

You're talking about Amy and Zainab And Zoey and all these British lactation consultants. So I'm very proud on behalf of the lifetime. Okay, I'm going to ask you a cheeky question to finish with, could you share with us one of the writing prompts that you use in your voice? And then it may be that some of some of our listeners might find that helpful as well. What give us an example of a writing prompt.

Katy Baker Cohen  1:01:26

With closure I have like I wrote a little bot blog post, I think it's called no man's land or something, you know, this area? And the writing prompts are there. Okay, perfect.

Emma Pickett  1:01:35

Well, well, let's put that in the show notes for sure. So I'm going to ask you to send me that link. But before we send people to that link, tell me about the Give me an example of a writing prompt.

Katy Baker Cohen  1:01:45

Yeah, the first two are just kind of like, you know, what am I gonna miss about breastfeeding? And then like, How will my child and I nurture and love each other when it's no longer through my pumped milk or nursing, but the one I end on which I have to give credit to my mom, who is does some creative writing and anyway, is, is the prompt is what I really want to say is dot dot dot. And so it's just this very open ended question. And kind of speaks to what we were talking about, like they might not have, like, what I really want to say. And you know, even at the last session, it was like, I'm so disappointed with our system, and that I have to even be here this evening and be you know, mulling over this or like it just, it just can bring up whatever they're really coming with and kind of get to that subconscious of like, unpacking a little more of the underlying feelings that are coming up around weaning or shifting their lactation journey.

Emma Pickett  1:02:37

Yeah, yeah, that sounds like an important open question to end on. I like the bit about starting on, what are you going to miss about breastfeeding? Because I think we do need to hold space for that. I think it's also important to acknowledge that somebody can be ending breastfeeding. And it's very rare that they are 100% certain this is this is going to be a positive experience. You know, you might be 51%, wanting to Wayne and still feeling like weaning is the right thing to do. And that 49% has a lot of stuff in it about, you know, how am I going to how am I going to parent when my child's ill you know, if my child has a temperature or they stop eating? How am I going to parent when they're teething what's gonna happen when they have a temperature? You know, it's what's gonna happen if they have a meltdown in public, and I can't breastfeed anymore. 

Katy Baker Cohen  1:03:22

It's, it's scary to imagine that the biggest exactly, that's the biggest one, and the most consistent answer is, I'm going to miss that moment of quiet togetherness that is hard to find in the rest of the world that is the most like it's not, yeah, like, you're saying, it's not like, I'm gonna miss the calories I'm giving my kid or whatever it is, you know, but it's like, the tool. It's like the extension of your parenting, you know? Yeah.

Emma Pickett  1:03:45

So for sure, you're gonna be parenting in a new way. And that is scary. And it's, and it's really okay to admit that that's scary. I sometimes joke about breastfeeding being like the Swiss Army knife, you're taking that pen knife, and you're throwing it in the river, and you're never going to see it again. And Yikes. And actually, that what you said there a moment ago about, this is the quiet moment I have with my child. I think one thing that that genuinely is quite challenging is if you are parent led weaning and your two or three year old is not keen, they're not going to want to hug you with just a hug. You may actually you're going to lose some physical contact potentially, in the short term, I'm really confident it'll come back around again, and you will end up hugging and having snuggly cuddly moments, but they're not going to come into bed and snuggle for 40 minutes without a breastfeed, then as far as they're concerned, that's an outrageous suggestion that they would do. If they're not breastfeeding, their bloody well going downstairs and they're going to have breakfast and stop playing and they're still going to be cross with you. You're gonna you're gonna lose snuggles you're gonna lose that physical contact time and, and your child might be angry with you for a while and not wanting to cuddle you for a while and that is a horrible concept that you that's probably why you know, waiting blues and the emotional impact of breastfeeding can be tough for people because they're losing the oxytocin that comes from that physical contact to that's One reason why I'm so big on weaning, not being quick, if you've got the time to do it, take your time, add in the other stuff first add in a couple times, add in the snuggly reading of the book, add in the hairdressing, and the manicures and the hand massage and the doing the yoga together and add in all the other physical stuff before us take the breastfeeding away. So your child is more likely to accept all those other methods and continue to accept them through the weaning process. Because if we if we abruptly remove breastfeeding, we're going to be d skilled, and we're going to lose the oxytocin. And we're going to have a very angry little person whose needs are not being met. So we want to take our time.

Katy Baker Cohen  1:05:38

I think one thing in the session that I believe is it is also open to people who are had their journey end before they wanted to, and this is a whole nother conversation. But it's interesting to hold space for both of those experiences. It definitely attracts people in the, you know, further than one year old group. But I would just say for the flip side of the coin, have I had someone just share that, now that they're not latching, they actually can look into their baby's eyes. Without that, you know, all the other stuff that latching brought, but it's just a complex, you know, and I think one of my one of my ulterior motives, ulterior motive is not to have people nurse longer. But I do have an ulterior motive with the session of just not that everyone needs to have a positive remembering of their lactation journey. But I think if you have space to process it, and like digest it, then when you're going out into the rest of your life, what stuck in your brain is that time that you did get to process and be proud of yourself, even if it didn't go how you wanted to, and just kind of have those things sinking, versus we weaned or it abruptly ended. And I carried on with my life. And now my only memories were like the struggle, even though the struggle is always gonna be there. But I don't know if that's making sense. But it's this like meta, a meta thing that I have a goal at the session of just like, You got to digest that you got to be proud of it, you got to fully like integrate that experience, and then take it and then, you know, that has generational impacts. I'm having high hopes here, but it does if someone if a parent, so it's not that grandmother who was like it's stuck for me, and all I have stuck in my head is that it sucked, you know, and so then, or it was really hard. So anyway, just wanted to know,

Emma Pickett  1:07:15

I love that. I love that. I think that's I think that's, that's really important when someone's been doing the weaning to reflect at the end. So I do this thing with clients, which I call a walk in the woods, which is literally a walk in some words, where oh, when the when the when the weaning is finished, we talk about the whole journey, because it's so you know, the last thing you remembered is the really hard effort of weaning, that's going to colour your whole breastfeeding experience. And, and that's one of the reasons I recommend that clients make books about their breastfeeding journey. So yeah, and it's not just for their child, it's for them to they can sit down together and say, let's look at this picture of when you're a baby, let's look at this picture, you know, all the way through so we can both together remember the positive times and that's doesn't mean that won't be some sadness there. But we're making space to focus on the positive times. Like that's, that's really important. Yeah, let's it's important to allow a little bit of hippie into your life, I think, crunchy in America, little bit of crunchy is not necessarily a bad thing if it helps people emotionally.

Katy Baker Cohen  1:08:09

Like basic psychotherapy to write if you have like unfinished experiences or unfinished emotions, they kind of sit there unfinished. And so it's like a completing the cycle by processing it and having time to think about it.

Emma Pickett  1:08:23

Yeah, no, I like that. Thank you. So Katie, we'll put your website in the show notes. Do you ever have clients from around the world? By the way? I mean, do you have international people that join your group?

Katy Baker Cohen  1:08:32

I think I've had Canada. And then I've had, we've had, you know, I've had people from other states, but I don't think but I would very much welcome. Yeah. Anybody?

Emma Pickett  1:08:42

Cool, we might get a little bit of UK interest after this fall. So we'll put your link in the show notes. And we'll also, I'll also ask you to send me your blog post that we'll put in there as well with some of your writing prompt ideas. And, yeah, thank you so much for your time today, Katy, I really appreciate you so much. Let's keep talking because I think it's really great to meet someone else who works in this space and I look forward to hearing how the next steps go. 

Katy Baker Cohen  1:09:06

Thank you.

Emma Pickett  1:09:11

Thank you for joining me today. You can find me on Instagram at Emma Pickett IBCLC and on Twitter @MakesMilk. 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.