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This is a blog written by Victoria Greenly, a postnatal doula.  Here you will find my musings on all things postnatal and what it is like to be a postnatal doula.

By Victoria Greenly, Nov 23 2017 12:36PM

I will always remember when as a newly practicing postnatal doula a number of years ago, I went on to a local mums’ network on Facebook to promote my services and I read a post from a mother asking for support for her baby’s reflux from other mums. Her post received over one hundred comments in a couple of hours from other mothers whose babies had suffered in the same way and they wanted to share their knowledge and ideas.

I was shocked and disappointed that not only were so many babies suffering but also that their mothers were so distressed and overwhelmed. I started to research and try to understand what this new ‘epidemic’ was and how I could better support mothers in my role as a postnatal doula. As a result, I was often employed by mothers whose babies were afflicted by reflux. The parents themselves had felt that they were not being given good support from health professionals particularly GPs, especially as the first one-stop solution they were given was to feed the baby some Gaviscon – which often resulted in more pain for the baby due to constipation. There also seems to be little understanding on the correct usage of reflux medication. My clients were often confused and concerned as to whether the medication was a) really working and b) if there were possible side effects for the baby.

I knew I could give them better support if I improved my knowledge (additionally within my role as an infant feeding counsellor). There was very little published information despite all my research, so I had to collect information from a variety of sources and also through observing my clients’ babies. I developed new skills and became convinced that feeding babies optimally was one of the key elements in preventing reflux.

Over the last couple of years more information is coming to light, but from my experience the key things that have helped the parents I have supported with baby reflux are:

getting breastfeeding going in the most optimal way right from the start ie troubleshooting any problems with a baby’s latch, particularly tongue tie issues which need to be assessed by a breastfeeding specialist - and ensuring that feeds are completed by the baby in the way that preserves the baby’s natural feeding rhythm and so the baby gets a full feed

as little outside intervention as possible during breastfeeding, allowing babies some peace and quiet, not over-stimulating babies particularly during feeding and encouraging mothers to relax whilst they feed

not cramming too much in with young babies but following their natural rhythms, following their cues and giving them the time to develop at their own pace, particularly their fragile digestive systems

not delaying a feed – feeding on a baby’s cue

being consistent with feeding particularly when switching from breast to bottle and mixed feeding, particularly in the early days – this needs to be carefully managed by an infant feeding counsellor

not expressing too soon – again this needs to be carefully managed by consulting an infant feeding counsellor

ensuring that when bottle feeding, a mother practices ‘paced’ feeding and allows the baby to fully digest the milk at their pace, maintaining their feeding self regulation

when bottle feeding, checking a baby’s latch on the bottle and replicating breastfeeding as much as possible through position of the baby and bottle teat

exploring potential food intolerances particularly to cow’s milk protein and referring on to specialist support

I have used all these techniques with the clients I have supported and particularly encourage their use to prevent reflux occurring in the first place. Of course, there are many other things that may relieve some of the pain symptoms and aid digestive relief, eg wearing baby in a sling, encouraging babies to sleep in a slightly more upright position (although sleep positioners have now been withdrawn from many retail outlets), baby massage, cranial osteopathy and other therapies eg Bowen technique etc, mixing some weak fennel tea in with bottle milk, probiotics. As a postnatal doula, I present my clients with the options out there and encourage them to make an informed decision on which course they may like to take. But overloading parents with multiple options to ‘cure’ reflux can also be very stressful for them, particularly when they don’t see an improvement in symptoms.

As a postnatal doula course provider, we also prepare doulas with good information through our reflux section on a workshop we provide called Understanding Newborns.

By Victoria Greenly, Oct 13 2017 10:20AM

The concept of a postnatal doula has been around for thousands of years – think of the network of women who would support a new mother with babycare knowledge as well as emotional and physical nourishment, so that she could recover from birth and learn ways to take care of her baby. However, the role as we know it in its current form may be less familiar. Postnatal doulas have been around for a while and growing in numbers over the last 20 years but as a nationwide phenomenon, we are relatively new! The reason we are needed is important and I have written about this as a postnatal doula course provider on

When women are unsure of what a postnatal doula does and I explain, all of them that are already mothers say ‘gosh, I wish I had had one after my baby was born!’ So for those that are unsure, here is an explanation of what a postnatal doula does. The basic idea of what a postnatal doula provides is emotional, practical and informational support to a family after a baby is born. But what does this mean in reality? Well, as I have discovered from supporting many families over the years, what I actually do can be extremely varied and far reaching. I have honed my skills and provide a variety of different ‘services’. The families I support decide which of those services is important to them and use the ones that they feel are most relevant to their needs.

As my experience has grown, I now give them a written list of all the types of support I can give, from the practical to the emotional, as well as sharing knowledge and evidence based information. If I wrote them here, they would amount to a long list of bullet points, so it might be more interesting to get a snapshot of a day in the life of a postnatal doula. Postnatal doulas usually provide 3-4 hours of support 2-3 times a week. However, support is bespoke and tailored to the needs of each family so can be very varied – from the odd session here and there to overnight support and many sessions in a week.

A day in the life of a postnatal doula:

When I first arrive, I always check in with the family and see how they are doing. If a mother is on her own, I often explore how she is feeling both physically and emotionally, and talk through what’s been going on with her baby and how her baby is feeding. She will often want to talk through ideas for baby care. I never impose advice on her but give her options and suggestions from reliable information sources and what I have found might work from my years of experience working alongside other mothers. I like to think of myself as a knowledgeable sister but always ensure I encourage her to think about finding her own parenting way and what suits her choices. There is no limit to the time a mother might want to talk and we can spend many hours exploring ideas together. The basic tenet of being a postnatal doula is figuratively walking alongside a mother, so I am guided by her wants and needs.

In the back of my mind, though, is my desire to ensure she is physically nurtured after her baby’s birth. We know birth is a life changing event emotionally and physically, so giving a mother the space to recover is of utmost importance. During my time with her, I encourage her to rest whilst I look after her baby (and possibly other children). Whatever form that takes is up to her, whether it is going for a sleep, having some quiet time reading or simply having a long bath. To give her permission to remember that she is still a woman as well as a mother during what can be a very exhausting time, is extremely beneficial to her mental and physical wellbeing.

And the last thing, I really try to ensure is that she is nourishing herself with good nutrition. So often, when time is short new mothers forget to eat or grab something convenient that is full of empty calories. Over time, many of us have developed nutritious recipes as part of our repertoire, which we prepare for mothers whilst we are with them. Knowing that, she will have a least one meal that is full of the vitamins she needs for her recovery is very important to me. Encouraging her to eat healthy snacks and stay hydrated is also an important part of our role.

Of course, each session can vary as to what I offer a mother but hours can pass quickly and ensuring I have given her some respite and a listening ear is what I see as the crux of my role as a postnatal doula. But if you really want to read the long list here it is below:

Talking through and reflecting upon a woman’s birth experience (if she chooses), exploring birth trauma and helping her process what happened. Referring on to specialist organisations if desired.

Breastfeeding counselling and optimal infant milk feeding of her baby ie bottle feeding and formula (I am also a qualified breastfeeding counsellor). Postnatal doulas do provide infant feeding support based on their sphere of knowledge and level of experience.

Early parenting guidance and care of her baby – ‘understanding her newborn’, signposting and sharing knowledge and information from evidence based sources:

• Baby sleep

• Cues

• Soothing

• Development

• Parenting styles

• Patterns and rhythms

• Getting her baby into a ‘routine’ – what kind of routine would she like and what is possible? Understanding newborn behaviour through observation so that she can predict some rhythms. Explaining the ‘routines’ that are out there so she can explore ideas.

• Guidance on babywearing ie slings and carriers

• Bathing/washing – baby skincare

• Guidance on products she might find useful

• Monitoring baby conditions – to help her decide if she might want/need to refer on to a Healthcare Professional

Caring for her:

• Emotional support – exploring options and talking through feelings especially the transition to motherhood or if she is feeling low and anxious. (I have basic counselling skills), confidence building and moral support. Referring on to other mental health practitioners and HCPs if she feels she needs more support.

• Monitoring and supporting postnatal physical conditions, referring on to a Healthcare Professional when necessary or other practitioners eg osteopaths

• Practical support – looking after her baby so she can have a sleep/rest/bath/shower/time out, household management to keep on top of things

Information on natural remedies for her and her baby – signposting on to other practitioners

I am happy to undertake the following tasks:

light housework eg wiping down surfaces

running a hoover around

emptying the dishwasher

light washing up

putting washing in washing machine

organising the household eg sorting or hanging out clothes

packing school bags

basic shopping

running errands

light ironing

tidying up and putting toys away

In addition, I am happy to do the following:

looking after babies and children whilst she is in the house or if she needs to go for a short appointment

picking up children from nursery/school

taking babies and children out for a walk/play if local

accompanying her and baby to appointments

accompanying her for first trips on public transport

accompanying her for first trips breastfeeding in public

accompanying her whilst she buys baby products

Good nutritional support for a woman’s postnatal needs. Preparing meals for her and her partner and family meals including:

Lactogenic meals – to support her milk supply

Tasty and healthy meals to support her postnatally

Hearty family meals eg shepherd’s pie, homemade fish fingers, homemade chicken goujons and spaghetti bolognaise

Snacks and light meals

I am happy to explore meal options with a family dependent on their diet, preferences and culture. I have a full list of meals I offer.

Supporting partners – exploring the transition to fatherhood and exploring post baby relationships in same sex partnerships

‘Sharing the workload’ – exploring how families might ‘babyproof’ their relationships and keep tensions low

Introducing solids/complementary foods

This is my list. Each postnatal doula will work out what they will offer and do, based on the above and other skills – some offer alternative therapies eg reiki, herbalism, or massage. And that’s because there is a doula for every family.

By guest, May 22 2014 12:15PM

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