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Sharon Trotter RM BSc

Midwife, Breastfeeding Consultant and Neonatal Skincare Advisor

MIDIRS 2004 - breastfeeding

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Breastfeeding: the essential guide. Just another breastfeeding book?

The full reference for this draft article is: Trotter S (2004). Breastfeeding: the essential guide. Just another breastfeeding book? MIDIRS Midwifery Digest, 14:4, 459-62.

Abstract

"With more than 20 years experience as a midwife and seven years as a breastfeeding mother to my own babies, I wanted to write a book that could become 'the essential guide'. This book is perfect for women thinking about breastfeeding or interested in finding out more. It is easy to read, non-judgemental and above all realistic. Having returned to university myself, I realise the importance of evidence-based information and have included references where necessary. This will be especially helpful to midwives and students. Although I follow the 'Ten Steps to Successful Breastfeeding' used in maternity units, this is nonetheless a personal view of breastfeeding. I hope that it gives you the enthusiasm to give it a go and that you enjoy reading this book as much as I have enjoyed writing it. Happy breastfeeding!"
The above statement can be seen on the back cover of my first publication, Breastfeeding: the essential guide. I want this article to give you an insight into the process of self-publication and I hope my story will inspire other midwives to step out of their comfort zone and follow my lead. At times it has seemed daunting, but the rewards far outweigh the effort.

Introduction
A long gestation period…
Putting my head above the parapet…
Self-publication?
The birth of my own publishing company (www.tipslimited.com)…
The last Trimester
Expected Date of Delivery (EDD): August 2004
A new beginning…
References

Introduction

There is a staggering array of breastfeeding books on the market. These might approach the subject from a mother's perspective or offer a more professional view. Some follow the UNICEF (WHO 1998) 'Baby Friendly Initiative' guidelines to the letter, while others give only anecdotal advice. Could a simple 'tell-it-like-it-is' book really make a difference to falling breastfeeding rates, where so many others have failed to effect a change? As a midwife with more than 20 years experience of breastfeeding and seven years personal experience as a breastfeeding mother, I decided to stop complaining about the lack of inspired material and write my own.
Much is written about the reasons why breastfeeding is unsuccessful (Finigan 2004, Various 2004, New 2004) including: lack of support from professionals; poor information; insufficient Baby Friendly Initiative units; reduced maternity leave; cultural differences; media & marketing and little or no support from extended family. Whilst I agree that all these reasons play their part, I also believe that the successful establishment of breastfeeding is greatly improved by providing accurate information within a supportive environment. This information allows women to make an informed choice about whether and/or how to breastfeed. Women who are not given the opportunity to fully understand the benefits of breastfeeding may feel pressurised into what some of them describe as 'having to breastfeed'. Furthermore, all advice needs to be easy-to-follow, evidence-based, non-judgemental, realistic and above all enthusiastically presented and fun to experience. My ultimate goal is for breastfeeding to become the obvious choice instead of being the second choice, which is all too often the case. [back to top]

A long gestation period…

In many ways my book's development is analogous to the process of pregnancy and birth. Its conception took place in May 2002 when my youngest son, at 29 months old, was still breastfeeding.
I started to write down my thoughts and tips about breastfeeding and this quickly developed, so that within three weeks I had the embryo of a book. My world was suddenly complicated by terms like ISBN, CIP, Copyright, AAA, EPOS, MTA, ebook, rights and royalties. I will not explain all the above, except to say that the literary guidebook, 'From Pitch to Publication' (Blake 1999) and the Writers & Artists Yearbook (A&C Black 2003) became my constant companions. This period also heralded a steep learning curve that I felt obliged to climb. I could never have envisaged the convoluted path that would precede the arrival of my first title, not only as an author but also as the publisher. If I could give only one piece of advice to anyone considering self-publication, it would be to never lose sight of your original belief in yourself and your book. This will help you deal with the many inevitable 'ups' and 'downs'. I always believed that my book was worthy of publication and when publishers or agents turned me down, I moved on with renewed determination.
Having been published in peer-reviewed journals regarding my work on neonatal skincare and cordcare, (Trotter 2002, Trotter 2003 & Trotter 2004) I was encouraged to complete a BSc in advanced studies of midwifery at Paisley University. Thankfully the skills gained whilst writing articles proved invaluable when faced with academic assignments and also reaffirmed the importance of referencing. Over the past two years, my book has evolved [it is now fully referenced] following review upon review by a wide cross section of society. To date it has been read by over 80 friends and colleagues, 18 media personalities, 19 publishers and eight literary agents. Comments include:

"You're right I am a breastfeeding supporter of enthusiastic proportions. If I meet anyone useful I will most definitely pass on your book. In the meantime, good luck!"
Nigella Lawson, writer and cookery presenter

"I thought it was very interesting and informative and I hope that it is not long before you find a publisher. I'm sure a lot of new mothers would find it very useful - lots of luck with the project"
Eamonn Holmes, GMTV Presenter

"I adored the photographs in the book - they are charming! You certainly deserve to be published. I wish you all the luck in the world".
Claire Rayner, Author and President of the Patients Association

"I read it all, as soon as I got it. I am now four months pregnant and am very confident about breastfeeding this baby, thanks to your help and support. I hope you will write more books, as I would certainly buy it in the shops."
Mother of two formula-fed babies, hoping to breastfeed this one

"A very clear, simple to understand and compelling read for anyone considering breastfeeding. It is as if the Author is talking just to you."
Midwife and mother of two breastfed babies.

"If I was new to it all again, I would definitely consider breastfeeding, after reading your book".
Mother of two formula-fed babies

"This book would certainly have encouraged me to persevere with my attempts at breastfeeding (which were not successful, due to a lack of help, information and encouragement). It's easy to read, light-hearted and full of good advice - you can't go wrong!"
Mother of three formula-fed babies

"When I saw the amount of pages, I thought I would find it boring and end up not reading it at all. However, it was totally the opposite; it was a really informative read that is enjoyable at the same time".
Mother-to-be (now a successful breastfeeder!)

"I couldn't put it down! Even though I didn't manage to breastfeed my son 35 years ago! I found it a very enjoyable read. I just wish it had been around for me, and then I may well have been more successful."
Mature mother of one formula-fed baby

A few months after the draft copies were posted out, I received my first big break. Anne Diamond, journalist and TV presenter sent me a wonderful letter with an offer of writing a foreword. I was thrilled and sure that this would guarantee interest from publishers. Unfortunately, this was not the case. I remained encouraged by the positive feedback that continued to come in from literary agents, publishers, professionals, media personalities and most importantly mothers. It seemed that everyone wished me well with publication but no one was willing or able to give me financial backing.
Over the past three years I have been attending 'Women into Business', an organisation run by Business Gateway in association with the Scottish Enterprise Network. We meet monthly and have the opportunity to listen to other women's experiences in business, swapping advice and ideas. Their encouragement and support, freely given in an atmosphere of equality and openness, has contributed greatly to my own success. I was encouraged to take up Anne Diamond's offer of a foreword and create a professional draft of my book, which I could then promote. This was my next step. [back to top]

Putting my head above the parapet…

As a 'bank' midwife, I only work one or two shifts a week, which has given me time for my family and for writing. My work on skincare and cordcare is well known and I have been successful in introducing new guidelines on babycare advice for parents and staff within my local NHS organisation. However, only a few colleagues have been aware of my breastfeeding book. This was because I did not want to become discouraged by negative comments in the early stages of its development.
As Maggie Elliot, Royal College of Midwives (RCM) new President, so eloquently highlighted at her inaugural speech in Cardiff 2004:
"As midwives, we often chop down our 'tall poppies', those who speak out and challenge inappropriate or outdated practice. By behaving in this way, ostracising and criticising, we prevent new leaders from emerging…. It is essential that rather than focus on our own areas of practice, we value midwifery as a whole, putting women at the centre of care" (Elliot 2004)
Whilst attending the conference to present a poster on skincare and cordcare, I was not only privileged to hear this speech, but was also lucky to meet Maggie Elliot who inspired me by her example (see photo).
So, I am happy to 'put my head above the parapet' if it means I can make a difference. This is why I decided to surround myself with a small group of like-minded individuals who believed in me and by doing this; steady progress has been made in spite of some difficult days.
However, this does not mean I am unable to accept criticism. Indeed, during the research, development and proof-reading stages, it has been vital to take criticisms, opinions and suggestions on-board. To be completely objective, fresh pairs of eyes are often helpful. Throughout the past two years, I have listened, evaluated and updated accordingly, so that my book could evolve and grow into its present form. Because research is ongoing, 'Breastfeeding: the essential guide' will continue to evolve, even after publication. [back to top]

Self-publication?

In January 2003, a local newspaper ran a story about my search for a publisher. Whilst this did not produce the desired effect, it became the catalyst to putting my book online with www.authorsonline.co.uk as an e-book. I proof-read my book for any obvious errors, added a simple front cover and within days it was on the internet. At least people could go and look at my book, even if it was not yet available in a printed format.
Comments from publishers and agents fell into two categories and it soon became apparent that I was not going to find a publisher. The company was either too large and already promoted breastfeeding titles by other authors, or too small and could not do justice to marketing my book on the scale I had envisaged. I soon realised that I had already completed most of the work necessary to self-publish. To help pay for the first print run I decided to try and attract sponsorship in the form of adverts within the book. This was not an easy task and six long months of careful negotiations with various handpicked companies ensued. Thankfully, my work in the field of neonatal skincare and the recognition this has received along with the 'foreword' by Anne Diamond helped greatly.
[back to top]

The birth of my own publishing company (www.tipslimited.com)…

Another steep learning curve began once I had decided to start my own publishing company. I registered Trotters Independent Publishing Services Limited with Companies House; registered my domain names for my website; met with accountants and bank managers; attended business start-up seminars; registered with the Inland Revenue and designed logos for a corporate image (the duck on my logo is a light hearted link to my neonatal skincare work). I also spent weeks thinking and re-thinking the all-important front cover of my book. This had to be right if it was ever to stand a chance next to the competition. After 14 drafts, the winning version stood out from the rest and we had our front cover. This was a wonderful moment and a real turning point (see photo).
Some days, when I am snowed under with paperwork and the sheer enormity of what I am trying to achieve, I do think 'What am I doing?' but my original belief is still there and that, along with my patient husband and our four wonderful children, is what keeps me going. [back to top]

The last Trimester

By the summer of 2004, I had 10 promises of adverts. A draft copy of my book, complete with new front cover, was ready to send out to the breastfeeding associations. I had left this until late in the process because, above all, I wanted my book to remain light hearted, chatty and a lifeline to all who read it. This would not have been possible if I had been restrained by political correctness. I was surprised and reassured that, although there were many suggestions for changes, most were easily incorporated without upsetting the informal flow of the text. I would like to thank all the breastfeeding organisations for their input and for being so frank. This process was extremely helpful and enabled me to fine-tune the book before going to press.
Although the information and advice in my book is evidence-based and follows the 'Ten Steps to Successful Breastfeeding', as recommended by the UNICEF Baby Friendly Initiative, it is nonetheless written with a personal understanding of the subject, plus an added helping of humour. I do not profess to be a breastfeeding counsellor and my book is not an academic textbook. This said, it does contain an enthusiasm and passion for breastfeeding that I hope will shine through every page so that, by the end of the book, the reader feels ready to give it their 'best shot', be that as a teacher or anyone wishing to learn. [back to top]

Expected Date of Delivery (EDD): August 2004

At the time of writing this article my 'new baby' has almost reached its EDD. The final discs are with the printer and I am truly overwhelmed that my little book will soon be available for everyone to buy. When I received my ISBN number I checked it out on Amazon and there it was on the screen! It wasn't yet printed but it was ready to pre-order from my very own publishing company.
I would like to thank everyone who has shown an interest and helped me along the way. You know who you are and I will be forever grateful. Without the help of my sponsors I could not have published my book, so I also wish to extend my sincere thanks to them. [back to top]

A new beginning…

The task of marketing my book is already well underway and review copies will be making their way to professional journals, mother & baby magazines, breastfeeding organisations and retail outlets in the coming weeks. My first order of 20 copies will also be sent out to NHS Borders, who were brave enough to put their faith in me, long before my book's completion. Preparations are also underway to organise a launch party that will introduce my book to the general public. I have no idea what the reaction will be but I hope it is as positive as the pre-publication comments.
I hope that my story will inspire other midwives to step out of their comfort zone and follow my lead. At times it has seemed seem daunting, but the rewards have far outweighed the effort. [back to top]

References:

A & C Black (2003). Writers & Artists Yearbook. A & C Black Publishers. London.

Blake C (1999). From Pitch to Publication. Macmillan. London.

Elliot M (2004). The RCMs new president speaks out. RCM Midwives Journal. 7(6): 232.

Finigan V (2004). Breastfeeding -The Great Divide: the controversy as seen through a midwifery lens. MIDIRS Midwifery Digest. 14:2 p 227-31.

New S (2004). Breastfeeding rates in Sweden and the UK - What can we learn from them? MIDIRS Midwifery Digest 13(4): 115-8.

Trotter S (2002). Skincare for the newborn: exploring the potential harm of manufactured products. RCM Midwives Journal 5(11): 376-8.

Trotter S (2003). Management of the umbilical cord - a guide to best care. RCM Midwives Journal 6(7): 308-11.

Trotter S (2004). Care of the newborn: proposed new guidelines. British Journal of Midwifery 12 (3): 152-7.

Various (2004). Listening to all sides of the argument. RCM Midwives Journal. 7(2): 86.

World Health Organization (1998). Evidence for the ten steps to successful breastfeeding. Geneva. WHO. 1998.

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© Sharon Trotter 2013
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